Saturday, May 9, 2009

Age is Just a Number

Dara_Torres became my instant hero when I learned she was competing in the 2008_Olympics at age 41. I have since discovered that we have more in common than I first thought. First, my post title is the same title of her new book, which is featured in the April issue of More_magazine. Second, we are both 42. Third, we have both done IVF. The similarities end there.

Dara is married to a fertility doctor (!) and had a daughter from IVF at age 38. It's interesting what she writes, though brief, about her infertility experience. She says that infertility was the one thing that she could not control. I was so inspired by Dara's wins at the 2008_Olympics and her drive to compete even more today, but is it really true that we have no control over our fertility as we age? I would like to think we do.

I have let my age get the best of me these last few days and weeks. How at age 42-and-less-than-six-months-away-from-43 can I even consider cycling with my own eggs? I thought for sure that I was doomed and my Day 3 FSH would come back sky high. I had a meltdown yesterday morning, letting these negative thoughts get the best of me, though I still had not seen my Day 3 results yet.

The truth is not so bad. My numbers are not spectacular, but they are pretty damn good considering my age. I was unsuccessful in getting the AMH test, but I did get FSH and estradiol:

FSH = 4.4Estradiol, Serum = 61

The first number rocks, but the second number is the one I'm concerned about. I believe that BigShotFertilityClinic likes to see this number below 50 on Day 3. Those of you who also go to BigShotFertilityClinic (there can only be one in the US, you know), please chime in about what you know. The theory goes that if you have a low FSH and "advanced maternal age", you also have to look at estradiol because a high estradiol can mask a low FSH. I'm not exactly sure what is considered a high estradiol, and I think it depends on where your labs were run. Dr._Liccardi says 50 is the cut off. This fertility clinic puts the cut off around 70-80, with the caveat that the number really depends on the lab where your bloodwork is done. The one number I am missing that I needed was the anti_mullerian_hormone (AMH), which I thought was ordered.

The other theory about high estradiol on day 3 is that your follicles start growing and producing estrogen early, which is basically interpreted as bad egg quality. One reason I am not entirely concerned about my sketchy E2 level is that my last cycle was long for me, 28 days. A "normal" cycle for me is 24 days and has been that way all my life. My sister is the same way, and she has three children, one who was conceived at 40 years old, no problem. My cycle was so long, that I actually peed on a stick the morning of the 29th day, but of course, it was negative and AF showed up shortly thereafter. I would not be surprised if my follicles did start growing a bit early, as they might have been confused by this seemingly long cycle for me.

Consider too, that the last time my antral (resting) follicles were counted, I had seven, which I thought rocked for my age, but again, this fertility clinic shows that the numbers were sketchy. Ten or over is the acceptable number. I'm figuring, a little estrogen_priming_protocol and a lot of ovarian stimulants will get that number higher for me. I'm not in it for the quantity. I would be happy with one good embryo out of the whole lot.

Having taken graduate statistics, I'm all too aware of how statistics do not tell the whole story. I am not doing IVF because it has been proven that I have egg quality/fertility issues. I'm sure that if my husband had swimmers, we would have been knocked up a long time ago. Not to say that we couldn't use IVF now at my age, but still, I don't have the double whammy of age and fertility problems. Most of the women doing IVF at my age do have fertility problems, so I believe that could skew the statistics. If I am going to plunk down $20-$25K that I don't have on another IVF cycle, I want to know that I have more than a snowball's chance in hell of success. I think my recent numbers show that hell just got a little colder. I feel comfortable going ahead with my plan of improving my egg quality as much as possible in the coming months to go forward with another IVF cycle. As comfortable as one can get with doing IVF again, that is.

12 comments:

DOn't get caught up in numbers (I had zero antral follicles when we began our ivf) not that that turned out great, but, it's all not that relevant.WOW with the FSH - that's great (and lower then the 30 year olds). So you're doing good Pheobe. hugs to you

I think the numbers only tell a part of the story. Yes, Big Shot Clinic thinks an E2 over 50 masks the FSH a little bit. But, this is why they picked the completely wrong protocol for me, plus my lowish AFC. I think it's better to look at past response personally.That is one heck of an awesome FSH!!

I was 32 when the BigShotClinic took my Day 3 #'s. My E was over 50, I think it was at 55, actually. But My FSH:LH has always been messed up due to PCOS, so they said it wasn't a big deal. My thoughts were that it messes up their statistics if they go too aggressive, so I figured they only like to try IVF if it's a good case. They kept pushing IUI on me I believe because well, I couldn't afford IVF, and with PCOS I would have a huge chance of multiples. I did have to stick up to them on when to scan as my cycles are very long (38 days on a good cycle). Be your own advocate and don't settle for less!

What a great FSH. I don't understand much about the FSH/estradiol connection, so I don't have anything to offer - except that I am thinking about you and wishing you the best in these upcoming decisions.

I also don't understand much about numbers, but I believe they can change depending on our stress levels, and other emotional stuff too. So acupuncture is a great thing that you are doing. I was doing acupuncture and watching my diet in crazy chinese ways last year and had a borderline FSH at age 33. I want to take that test again, now that I"m not so freaked out, just to see what happens. If age can be just a number, then numbers can be just numbers too. ;)

Wow that's a great FSH number! I agree with PP's that THAT CLINIC likes to see it less than 50 but you're pretty close and besides, it could change next month. I didn't know about Dara Torres and her history of being married to a fert doctor (now why didn't I think of that?) but that is interesting to know. She truly is an inspiration.

I'm not good with the numbers either. Didn't even ask that fertility clinic what my E2 was...was just overly concerned with FSH and AMH. And your FSH kicks mine's butt! Numbers aren't everything. In Oct I cycled with a woman who was 5 years older than me, had high FSH (really) and got a total of 3 eggs and she stayed pregnant, I got 19 and miscarried. These things just don't always make sense. Oh- and that woman took DHEA! Good luck.